Individual provider Active NPI

Ashley Gross, FNP

  • Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1265959316
Registry record updated Dec 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0000022920 Issued in TN
Practice address
411 Princeton Rd Ste 101
Johnson City, TN 37601-2049
Phone
(423) 461-0021
NPI assigned
Aug 29, 2017
Last updated
Dec 18, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0000022920 TN Primary

Addresses

Primary practice location

411 Princeton Rd Ste 101
Johnson City, TN 37601-2049

Mailing address

411 Princeton Rd
Ste B
Johnson City, TN 37601-2049
Phone (423) 461-0021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180123003568 TN Order and Referring Only - Nurse Practitioner 5799044525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513555200000",
    "number": "1265959316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 PRINCETON RD",
            "address_2": "STE B",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012049",
            "telephone_number": "423-461-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 PRINCETON RD STE 101",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012049",
            "telephone_number": "423-461-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "ASHLEY",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-29",
        "last_updated": "2017-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "0000022920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.